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Effectiveness of Education Using Videos and VCO

Application Modules in Reducing ISPA Symptoms in

Children

Nurwahidah

, Syaiful

, Aniharyati

, Fitrah Abubakar

, Masruroh

Bima Nursing, Politeknik Kesehatan Kemenkes Mataram , Indonesia

1,2,3,4

Nursing, Faculty of Health Sciences, Universitas Pesantren Tinggi Darul Ulum

Email : nurwahidahmaskur34@gmail.com

Keywords

ABSTRACT

ISPA, Education, Modules, Videos,

Knowledge, Skills .

Acute respiratory infections are one of the most common causes of

death in children. Around four out of fifteen million estimated deaths

are in children under 5 years of age.. ISPA is a disease that often

occurs in developing countries and is one of the causes of patient

visits to health centers (40%-60%) and hospitals (15%-30%). The

five provinces with the highest ISPA are, NTT (41.7%), Papua

(31.1%), Aceh (30.0%), NTB (28.3%), and East Java (28.3%). Based

on the NTB Health Profile (2020) in 2019, ARI was the number one

case in the category of the 10 most common diseases in NTB with the

highest number of visits, namely 174,213 visits (NTB Health Office,

2018). Based on the results of the Indonesian Health Profile in 2020,

the number of patient visits with ISPA in the NTB area was 182,204.

Based on data from the 2020 Indonesian Health Profile, NTB is

ranked 6th with the highest number of patient visits with ISPA in

Indonesia. Quantitative research with a quasi-experimental

approach with control group design. The sampling technique was

consecutive sampling with 100 respondents. The results of the

paired sample T test data analysis showed that the knowledge of the

intervention group had ap value of 0.000 < 0.05 and the control

group had ap value of 0.01 < 0.05. Then the skills of the intervention

group obtained ap value of 0.000 < 0.05 and the control group

obtained ap value of 0.05. These results show that Ha is accepted and

H0 is rejected so it can be interpreted that there is an educational

effect using videos and the VCO application module in reducing ARI

symptoms in children.

INTRODUCTION

Acute respiratory infections (ARI) are one of the most common causes of death in children in

developing countries. About four out of fifteen million estimated deaths of children under 5 years old.

(Wiwin, Syaiful, & Rasimin, 2020). ISPA includes air bone disease, which is transmitted through the air

(Ministry of Health, 2017). ISPA can attack all age groups, but toddlers are most vulnerable to being

infected with this disease because toddlers have immature immune systems and they tend to come into

contact with other people who may be sick or facilities and equipment that are not necessarily

guaranteed to be clean so toddlers tend to be at higher risk of being infected. disease (Wilson, Wang, &

Meads, 2006). One disease that easily attacks toddlers, especially if there is a source of infection both

inside and outside the home, is ARI (Mirtha et al., 2016).

ISPA is a disease that often occurs in developing countries and is one of the causes of patient

visits to health centers (40%-60%) and hospitals (15%-30%). ISPA is caused by viruses or bacteria. This

disease begins with a fever accompanied by one or more symptoms: sore throat or painful swallowing,

runny nose, dry cough or phlegm. The ISPA prevalence period is calculated within the last month of the

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, Syaiful

, Aniharyati

, Fitrah Abubakar

, Masruroh

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Indonesian Ministry of Health (2019). In general, there are 3 risk factors for ARI, namely environmental

factors, individual child factors and behavioral factors (Alimul, 2008).

The five provinces with the highest ISPA are, East Nusa Tenggara (NTT) (41.7%), Papua (31.1%),

Aceh (30.0%), West Nusa Tenggara (NTB) (28.3%), and East Java (28.3%). Based on the Indonesian

Ministry of Health (2019), the highest characteristics of the population with ISPA occur in the 1-4 year

age group (25.8%). Based on the NTB Health Profile (2020), in 2019 ARI was the number 1 (one) case

in the category of the 10 most common diseases in NTB with the highest number of visits, namely

174,213 visits (NTB Health Office, 2018). Based on the results of the Indonesian Health Profile in 2020,

the number of patient visits with ISPA in the West Nusa Tenggara (NTB) area was 182,204. Based on

data from the 2020 Indonesian Health Profile, West Nusa Tenggara is ranked 6th with the highest

number of visits from patients with ISPA in Indonesia.

Knowledge is the result of human sensing or the result of a person's knowledge of objects

through the senses they have (eyes, nose, ears and some of them), most of a person's knowledge is

obtained through the sense of hearing (ears) and the sense of sight (eyes), a person's knowledge of

objects has intensity or different levels (Notoatmodjo, 2017). Mother's knowledge about ISPA is one of

the factors that plays a very important role in protecting toddlers from ISPA, such as how to prevent and

treat it so as to improve skills. Mothers who lack knowledge about preventing ARI can cause wider

infections that attack the lower respiratory tract system and cause systemic complications, chronic

pneumonia can cause death in children. This can be based on the mother's level of knowledge in

protecting toddlers from life-threatening diseases, both contagious and non-contagious. One effort that

can be made to increase mothers' knowledge about managing ISPA is by providing health education.

This increase in knowledge is really needed by mothers in order to understand the management and

prevention of ISPA, health education is an important illustration of the role of professional nurses in

health promotion and disease prevention (preventive) efforts (Fitriani, 2011)

Modules and short videos can help increase people's knowledge and skills in recognizing signs,

symptoms, early detection, and providing appropriate treatment for ISPA sufferers. According to

research conducted by Anjarina Witianti Putri, et al in (2021), there was an increase in public knowledge

and prevention of ISPA with poster and video media in Ujung-Ujung Village, therefore the current

research wants to try modules and short videos in reducing the incidence of ISPA in different places

(Forbes et al., 2016; Green et al., 2019).

Factors that cause ISPA. ARI can be caused by viruses, bacteria, rickettsia. Bacterial infection is

a complication of ISPA by viruses, especially if there is an epidemic/pandemic. Bacteria that cause ISPA,

for example from the genus Streptococcus, Haemophylus, Staphylococcus, Pneumococcus, Bordetella,

and Corynebacterium. Viruses that cause ARI include the Mixovirus group (influenza virus,

parainfluenza, respiratory syncytial virus), Enterovirus (Coxsackie virus, echovirus), Adenovirus,

Rhinovirus, Herpesvirus, Cytomegalovirus, Epstein-Barr virus. Fungi that cause ARI include Aspergillus

sp, Candidia albicans, Blastomyces dermatitidis, Histoplasma capsulatum, Coccidioides immitis,

Cryptococcus neoformans. Apart from that, ISPA in children is caused by the mother's lack of knowledge

and attitudes about ISPA (Bodovski & Youn, 2010; Mortensen & Barnett, 2019).

Based on the description above, researchers are interested in conducting research on the

effectiveness of education using videos and VCO application modules in reducing ARI symptoms in

children.

METHODS

Quasi experimental research design Design with pre test and post test with control group design.

This design attempts to reveal cause and effect relationships by involving a control group in addition to

the experimental group. The experimental group was given treatment while the control group was not

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and both groups underwent a pre-test and post-test (S. Nursalam, 2013). The research was carried out

in the work area of the Bolo Community Health Center, Bima Regency, February – June 2023 .

Determining the number of respondent samples uses the hypothesis sample size estimation

formula with a difference of 2 independent group means (Dahlan & Pengambilan, 2009) as follows:

n1 = n2 = (zα + zβ).S 2

(X1 – X2)

Information :

n = Number of samples

Zα = Standard deviation Alpa = type I error = 95% = 1-0.95 = 0.05 = 1.96

(Zα (2-tailed) distribution table).

Zβ = Power of test = type II error = 80% = 1- 0.8 = 0.2 = 0.842

X1 – X2 = The mean difference between the intervention group and the control group which is

considered significant based on the literature is 0.79

S = Estimated standard deviation of the intervention group and control group is 1.58

n1 = n2 = ( (1.96 + 0.842).1.58 )2 = 25,863

(0.79)

The minimum sample size in this study for health workers is based on this formula for the

sample size for the intervention group rounded to 50 respondents in the treatment group and 50

respondents in the control group.

The sampling technique uses consecutive sampling, which is a sample sorting method that is

carried out by selecting all individuals encountered who meet the selection criteria, until the desired

sample size is met (Dharma, 2011). So that the sample characteristics do not deviate from the

population, before sampling, inclusion and exclusion criteria need to be determined.

collection in research This with use charging sheet questionnaire . Then done observation before

and after given modules and videos against enhancement knowledge and skills application of VCO in

prevention of ARI.

1. Researcher introduce self to candidate respondent , conveyed information research , explained

objective research , procedures research and ask willingness candidate respondents For participate

as respondents in study with fill in sheet agreement study

2. Pre-test given to willing mother participate as respondents with requested For fill in questionnaire

. Activity pre-test done on the day 2nd , with use PPE in the form of a mask with consideration

spared from spread of the covid-19 virus. Then carried out a pre-test before given treatment form

modules and videos against knowledge and skills Mother in lower ARI symptoms using VCO

application .

3. Treatment : Counseling health done on the day 3rd . Group treatment given counseling with video

media and in groups control given counseling with media modules . Counseling done for 30-35

minutes , starting with phase orientation for 5 minutes , media playback is performed for 15

minutes , and discussion as well as closing for 10-15 minutes , done for 1 week with 3 meetings .

4. After counseling finished done post test For measure knowledge and skills mother .

In this study, a questionnaire to measure knowledge and attitudes was given to respondents

who were not part of the sample and a validity test was carried out on 46 respondents at the District

Health Center. Bima. Then each questionnaire is given a score according to the assessment system

applied. Next, it was tested using the Pearson product moment test. In this study, the rcount is

greater than the rtable, which is significant at 5%, namely 0.291, so the difference in scores for each

item is significant, so the knowledge questionnaire is declared valid.

Table 1. Questionnaire 1

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, Syaiful

, Aniharyati

, Fitrah Abubakar

, Masruroh

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Total

Pearson Correlation

,399

,417

,336

,462

,417

,462

,336

Sig. (2-tailed)

,006

,004

.023

,001

,004

,001

.023

Then the same test calculation was carried out on the skills questionnaire and it was found that the r

calculated value was greater than the table, so the difference in scores for each item was significant, so

the questionnaire was declared valid.

Table 2. Questionnaire 2

Total

Pearson Correlation

,445

,470

,336

,349

,336

,430

,462

,445

,389

Sig. (2-tailed)

,002

,001

.023

.017

.023

,003

,001

,002

,008

RESULTS

Based on research conducted by researchers, general data was obtained including the characteristics of

respondents consisting of age and level education , employment , knowledge , and skills before and after

the intervention in the form of modules and videos are presented in the following table:

Table 3. Characteristics of Respondents Based on Age , Education Level, Occupation and

Intervention Group Control Year 2023

Respondent Characteristics

Respondent Group

Intervention

Control

Age

Early adulthood age 26 - 30 years

38.0

0.658

Late adulthood 3 1 - 3 5 years

32.0

36.0

Early old age aged 3 6-40 years

30.0

26.0

Level of education

JUNIOR HIGH SCHOOL

12.0

0.381

SENIOR HIGH SCHOOL

38.0

50.0

Work

IRT

26.0

0.436

Private

26.0

22.0

Honorary

20.0

24.0

Civil servants

28.0

Based on table 3 , it can be seen that the majority of respondents in the intervention group and

control group were aged 26-30 years, which was in early adulthood , namely 19 people ( 38 %) with

mark p value 0.658 which shows proportion age respondents between group interventions and groups

control equivalent , most respondents have level PT ( University ) education as many as 2 5 people ( 50

%) in the group interventions and groups control with mark p 0.381 which shows proportion level

education respondents between group interventions and groups control equivalent , Respondent part

big own work as civil servants were 14 people ( 28 %) in the intervention group and control group with

mark p 0.436 which shows proportion age respondents between group control and group treatment

equivalent .

Table 4. Frequency Distribution of Knowledge and Skills In the Intervention Group and Control

Group Before and After Treatment in the Work Area Bolo Community Health Center, Bima

Regency Year 2023

Variable

Pre Test

Post Test

Intervention

Control

Intervention

Control

Knowledge

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Good

0 %

60 %

46%

Enough

62 %

50%

40 %

54%

Not enough

38 %

50%

0 %

Skills

Good

0 %

58 %

34%

Enough

56 %

54%

42 %

64%

Not enough

44 %

46%

0 %

Based on table 4, it can be seen that most of the respondents' knowledge measurements in the

intervention group pre-test were in the sufficient category, namely 31 people (62%) and almost half

were in the poor category, namely 19 people (38%). Then in the control group, the majority were in the

sufficient category, namely 25 people (25%) and in the poor category, namely 25 people (25%). After

being given treatment, the results of the post test scores showed that almost all respondents' knowledge

was in the good category, namely 30 people (60%) in the intervention group and most of the

respondents' knowledge was in the sufficient category, namely 27 people (54%) in the control group

and a small portion was in the good category, namely 23 people (46%). In measuring the skills of

respondents in the pre-test intervention group, most were in the sufficient category, namely 28 people

(56%) and most were in the poor category, namely 22 people (44%). Then, in the control group, most

were in the sufficient category, namely 27 people (54%) and most were in the poor category, namely 23

people (46%). Then, in the post test measurement of the intervention group, it was found that most of

the respondents' skills were in the good category, namely 29 people (58%) and in the sufficient category,

21 people (42%). And in the control group, the majority were in the good category, namely 20 people

(40%) and the majority were in the fair category, namely 30 people (60%).

Table 5. Analysis of Differences in Average Knowledge Values Before and after videos and

modules provided in the work area Bolo Community Health Center, Bima Regency Year 2023

Knowledge

Descriptive statistics

Paired t - test

mean (Std. D)

Δmean

Intervention

Pre-test

5 0

4.84 ( 1.235 )

2.9

-26,888

0.0 00

Post-test

5 0

7.74 ( 1.157 )

Control

Pre-test

5 0

4.64 ( 1.120 )

2.7

-24,199

0.0 1

Post-test

5 0

7.34 (1,062)

Table 5 explains test results were obtained average value of knowledge in the group pre-test

intervention , namely 4.84 then The average post-test score is 7.74 with p value equal to 0.000 < 0.05.

Then to groups control obtained The average value of pre-test knowledge is 4.64 and the average value

of post-test is 7.34 with p value equal to 0.01 < 0.05. On the second group You're welcome happen

enhancement knowledge , however based on mean value in the group intervention happen

enhancement of 7.74 or difference of 2.9 and 7.34 or difference of 2.7 across groups control . So you can

concluded There is difference significant between mean knowledge Mother before and after given

education VCO application in reducing children's ARI symptoms in the group interventions and groups

control .

Table 6. Analysis Difference in Average Skill Scores In the Intervention Group and Control

Group Before and after videos and modules provided in the work area Bolo Community Health

Center, Bima Regency Year 2023

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, Syaiful

, Aniharyati

, Fitrah Abubakar

, Masruroh

IJSSR Page 2508

Skills

Descriptive statistics

Paired t - test

mean (Std. D)

Δmean

Intervention

Pre-test

5 0

4. 70 ( 1.23 3)

2.98

-26,501

0.0 00

Post-test

5 0

7. 68 ( 1.1 68)

Control

Pre-test

5 0

4. 52 ( 1. 282)

2.58

- 17,038

0.0 5

Post-test

5 0

7. 10 (1,147)

Table 6 explains test results were obtained average skill value group intervention on the pre-

test , namely 4.70 then average post test score namely 7.68 with p value equal to 0.000 < 0.05. Then to

groups control obtained The average pre-test skill score is 4.52 and the post-test average score is 7.10

with p value of 0.05. On the second group You're welcome happen enhancement skills , however based

on mean value in the group The intervention provided by the media is in the form of a short video

happen enhancement of 7.68 or difference of 2.98 between groups intervention and 7.10 or difference

of 2.58 in the group control provided by the media in the form of module .

Discussion

Characteristics of Mothers in Work Areas Bolo Community Health Center, Bima Regency Year

2023

This study show that the average age woman age fertile aged 26-30 years , while in education

show that respondents part big educated College. One influencing factors knowledge is level education

, where level more education tall influence perception somebody For take decision and act . The more

tall level education you have mother , increasingly It is also good for preventing ARI and more low

education you have Mother so the more bad prevention ARI disease . Compare backwards with research

that states that No There is connection between level education Mother with ability Mother nurse ISPA

toddlers at the respondent's Bahu Community Health Center can seen from respondents with level

junior high school education has good ARI care compared to with educated respondents high.

Respondent's education Can influential to knowledge somebody However No means No If

educated low so knowledge become low anyway, besides That mother who pays attention condition

health child will more know about sign symptom beginning disease so that can do correct action .

Although respondents in study This the most is educated College and high school educated however For

knowledge about ISPA evenly or No Far different with respondents educated high . Knowledge can

increase and influence somebody if that person often interact and earn information from outside like

from friends , neighbors and related media ARI disease .

Analysis results showing part big Mother Work as a civil servant. Work influence knowledge ,

frequent person interact with others will more Lots exposed information or knowledge compared to

with people without There is interaction with other people. A Mother House busy stairs with work will

seldom interact with family or with another mother when currently guard his son and rarely play

accompany child outside so that can seldom can exchange information and experience One about each

other information health .

Knowledge And Skills In the Intervention Group and Control Group Before and after providing

education Through Video and VCO Application Module in Reducing ISPA Symptoms in Children

in Work Areas Bolo Community Health Center, Bima Regency Year 2023

Research results on measurements knowledge obtained average pre-test knowledge score in

the group intervention namely 4.84 and the average score on the post-test is 7.74. This thing signifies

there is difference or happen enhancement after given treatment . Then group pre-test mean score

control namely 4.64 and the average post-test score is 7.34. From the results second group the can seen

happen increase in the average score of pre-test and post-test. However average post-test score in the

group treatment Far more tall than the group control . In research by Adawiyah, (2021), Syahrani (2012)

stated that education health can increase knowledge and skills Mother in do maintenance toddler with

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ISPA. Then results study Huriah (2008) also states that education health give significant influence to

enhancement knowledge , attitudes , skills , and practices Mother in do maintenance toddler with ISPA.

Research conducted by Suyami et al. (2014), proves that education using leaflets, videos and baby

phantom media increase efficacy self in 18.2% of mothers in treating LBW with ( p value <0.05).

It is necessary to increase maternal knowledge regarding the understanding and prevention of

ARI diseases. In research, Aggraini (2019) said that maternal knowledge can influence maternal actions

in preventing ISPA. Increasing maternal knowledge about ISPA will be directly related to reducing the

incidence of ISPA. This low level of knowledge is caused by low education, lack of information, low

economic status. Mothers' knowledge regarding caring for children affected by ISPA is one of the most

common causes of death. Increasing knowledge by providing health education through the media will

be more fun and attract attention, so it is easy to understand and remember. Health education is also a

dynamic process of change, where change occurs because of awareness within the individual or society

itself (Naziyah & Pramudyawati, 2019).

In research This researcher using visual media in the form of modules and audio-visual media

in the form of videos. This was explained by Cone Edgar Dale's experience in Susilowati (2016) explains

that read information from the media can increase ability remember by 10%, then see picture from

information media can increase ability remember by 30%, more Lots senses used somebody in catch

information , then will the more his abilities are good somebody in remember information that . Apart

from that , it was also stated that ability Power remember to providing verbal and visual media for 3

days after given that is by 65%. By general , video media has more advantages Lots compared to

module media from facet visual appearance as well various pictures , also more explanations concise ,

p This regarding with the more many senses used in absorption information , of which video media is

one media type audio visual that relies on sense hearing and senses sight . Audio visual media is wrong

one medium that can used in learning listening.

Videos can serve information , explaining the process, explaining complex concepts , teach

skills , abbreviate or extend time , and can influence attitude . This thing in line with study Kasanah

(2015) shows that video media is more influential compared to leaflet media practice foot care for

diabetes mellitus patients . Video media is influencing variables enhancement behavior maintenance

Mother with pneumonia in toddlers . This thing in line with research by Wea (2015) states that

education health with video media improves behavior Mother in handling infection channel breathing

acute in toddlers in the village Lebijaga regency Nada .

Analyze Knowledge And Skills In the Intervention Group and Control Group Before and after

providing education Through Video and VCO Application Module in Reducing ISPA Symptoms in

Children in Work Areas Bolo Community Health Center, Bima Regency Year 2023

Based on the results of research on the knowledge of respondents in the treatment group, it was

found that p value = 0.000 < 0.05, this shows that there is an influence of audio-visual media in the form

of short videos on mothers' knowledge. And for skills, the p value = 0.000 < 0.05, this shows that there

is an influence of audio-visual media in the form of short videos on mothers' skills. Then in the control

group, the p value was 0.005 < 0.05, so it can be concluded that there is an influence of the media module

on maternal knowledge. And for skills, the p value = 0.005 < 0.05, this shows that there is an influence

of the media module on the mother's skills. Knowledge is the result of knowing and occurs through the

five human senses. A person's knowledge about an object contains two aspects, namely positive and

negative aspects. This statement is supported by research that there is an influence of mother's

knowledge on ISPA care skills for toddlers using the VCO application.

Enhancement knowledge This in accordance with study Fitria, Ida, et al (2016) that background

behind education person old is something element education that influences people old to set an

example, guide and directing children to go through development phases optimally. Parents with a

higher educational background are more likely to sensitive to development, And problem Which

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, Syaiful

, Aniharyati

, Fitrah Abubakar

, Masruroh

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currently faced child. With background behind education Which tall, person old can absorb information

so choose the right method in guiding and motivating children For improve cognitive abilities . In

research Kurnianingsih (2019) revealed that to increase knowledge need given method learning

education health Which interesting so that can involve all over five sense moment process learning.

Intervention using the booklet media provided only form writing And picture which is simple so it only

involves the sense of sight.

In the post test of the treatment group, it showed that all respondents experienced an increase

in positive attitudes and no respondents had a negative attitude. This is because respondents were given

intervention in the form of animated video modeling. Kartika et al., (2016) in their research stated that

the success of toilet training using modeling techniques is more effective than using oral techniques

because the advantage of modeling techniques is that they can be seen and imitated by respondents.

This statement is in accordance with the opinion of Nursalam, (2017) that toddlers prefer to imitate

what other people do, especially their family members. Mothers who are given animated video modeling

can provide good training through imitation of the steps in the video. Children will understand

something new more quickly by seeing other people do it. In line with Wiana's statement (2018) which

stated that " Media in learning has a function as a tool to clarify the message conveyed by the teacher ".

It can be concluded that media is a tool to clarify learning. According to Febriani & Irdawarni

(2019), the use and provision of media during learning makes it very easy for students to understand

the subject matter, namely material that is abstract and becomes concrete. Supported by Fahrurozi et

al., (2017) that multimedia is used to make lessons more interesting and at the same time provide

students with real examples of how multimedia works. Even though the respondents were not

completely able to do it themselves, there were changes in a positive direction in improving children's

abilities. According to Parulian et al., (2020), children's abilities are influenced by several factors,

including the child's interests, the child's experience, the child's environment, and the development of

the child's abilities.

CONCLUSION

Average value of knowledge in the group pre-test intervention , namely 4.84 then The average

post-test value is 7.74 with a p value of 0.000 < 0.05. Then to groups control obtained The average value

of pre-test knowledge is 4.64 and the average value of post-test is 7.34 with a p value of 0.01 < 0.05.

Based on mean value in the group intervention happen enhancement of 7.74 or difference of 2.9 and

7.34 or difference of 2.7 across groups control

Average skill value group pre-test intervention , namely 4.70 then average post test score namely

7.68 with a p value of 0.000 < 0.05. Then to groups control obtained The average pre-test skill value is

4.52 and the post-test average value is 7.10 with a p value of 0.05, based on mean value in the group The

intervention provided by the media is in the form of a short video happen enhancement of 7.68 or

difference of 2.98 and 7.10 or difference of 2.58 in the group control provided by the media in the form

of module .

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